Title
Patients with anaphylaxis to pea can have peanut allergy caused by cross-reactive lgE to vicilin (Ara h 1)
Author
Wensing, M.
Knulst, A.C.
Piersma, S.
O'Kane, F.
Knol, E.F.
Koppelman, S.J.
Publication year
2003
Abstract
Background: Serologic cross-reactivity among legumes has been described; however, it is rarely clinically significant. In this study 3 patients with a history of anaphylaxis to pea are described who subsequently had symptoms after ingestion of peanut. Objective: We investigated whether the peanut-related symptoms were due to cross-reactivity between pea and peanut proteins. Methods: Peanut-related symptoms were documented according to case history or double-blind, placebo-controlled food challenge results. Skin prick tests were performed, and specific IgE levels were determined for pea and peanut with the CAP system FEIA. IgE-binding proteins in pea and peanut were identified by using immunoblot analysis. Cross-reactivity was studied by means of immunoblot and ELISA inhibition studies with whole extracts and purified allergens. Results: Peanut-related symptoms consisted of oral symptoms in all patients, with additional urticaria and dyspnea or angioedema in 2 patients. All patients had a positive skin prick test response and an increased IgE level to pea and peanut. Immunoblotting revealed strong IgE binding to mainly vicilin in pea extract and exclusively to Ara h 1 in crude peanut extract. Immunoblot and ELISA inhibition studies with crude extracts, as well as purified proteins, showed that IgE binding to peanut could be inhibited by pea but not or only partially the other way around. Conclusion: Clinically relevant cross-reactivity between pea and peanut does occur. Vicilin homologues in pea and peanut (Ara h 1) are the molecular basis for this cross-reactivity.
Subject
Nutrition Health
Food technology
Ara h 1
Cross-reactivity
Pea
Peanut
Vicilin
allergen
immunoglobulin E
vicilin
adult
anaphylaxis
angioneurotic edema
antigen binding
article
case report
controlled study
cross reaction
dyspnea
enzyme linked immunosorbent assay
female
human
immunoblotting
male
pea
peanut
peanut allergy
prick test
priority journal
skin test
symptomatology
urticaria
Allergens
Anaphylaxis
Arachis hypogaea
Cross Reactions
Food Hypersensitivity
Humans
Immunoglobulin E
Peanut Hypersensitivity
Peas
Plant Proteins
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DOI
https://doi.org/10.1067/mai.2003.61
TNO identifier
236961
ISSN
0091-6749
Source
Journal of Allergy and Clinical Immunology, 111 (2), 420-424
Document type
article